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Reduced Nausea and Vomiting after Bone Marrow Transplantation with Aprepitant

Aprepitant was found to significantly reduce both nausea and vomiting when combined with other anti-nausea drugs in patients undergoing bone marrow transplants.

Seventy-three percent of patients receiving aprepitant experienced no vomiting during the study period, compared with 23% of patients who received a placebo. Both groups also received a standard anti-nausea drug. Forty-nine percent of aprepitant patients had no vomiting and little or no nausea, compared with 15% of the placebo group.

The study by Patrick Stiff, MD, and colleagues presented at the BMT Tandem Meetings received a Best Abstract Award from the Center for International Blood & Marrow Transplant Research, which sponsors the meetings with the American Society for Blood and Marrow Transplantation.

Aprepitant received FDA approval in 2003 to help prevent and control vomiting and nausea from chemotherapy, but there were only a few small studies on the benefit of aprepitant in bone marrow transplant patients, who typically receive higher doses of chemotherapy than most other cancer patients.

“We did not know how effective aprepitant would be for bone marrow transplant patients,” said Dr. Stiff, Director of Loyola University Chicago Stritch School of Medicine Cardinal Bernardin Cancer Center. “We now believe this should become a standard part of patients’ care.”

Other anti-nausea/vomiting drugs work by blocking signals from the stomach, but signals from the brain can still lead to feelings of queasiness. Aprepitant acts to block nausea/vomiting signals from the brain, and is taken together with drugs that block signals from the stomach.

The aprepitant group did not have significantly more side effects than the placebo group. Aprepitant also had no meaningful impact on the success of the transplant, relapse rates, or overall survival.

Loyola has the largest bone marrow transplant program in Illinois, a news release notes. “One of the main themes of our research is to make bone marrow transplants more patient-friendly,” Dr. Stiff said. “Transplants are much more comfortable and easier to tolerate than they were a few years ago.”